Maryland Licensed Utilization Management Nurse
Job Summary
Evaluating medical necessity and appropriateness of healthcare services, the part-time Maryland Licensed Utilization Management Nurse will conduct clinical reviews, coordinate with healthcare providers, and communicate with payors to secure required authorizations while working remotely.
Key responsibilities
- Review patient medical records to assess the appropriateness of admissions and continued stays
- Coordinate patient cases and ensure appropriate utilization of resources
- Communicate with internal and external stakeholders for service authorizations and appeals
Required qualifications
- Bachelor of Science in Nursing (BSN) required
- Registered Nurse License (RN) required
- Basic CPR certification required
- 5+ years of experience in clinical nursing required
Complete Job Description
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